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Rules and Policies for Treating Non-English Speaking Patients Print E-mail
Written by Jeffrey Segal, MD, JD and Michael J. Sacopulos, JD   
Thursday, 24 February 2011 10:13

"What we have here is a failure to communicate."

  According to the 2000 U.S. Census 18% of people living in the U.S. spoke a language other than English in their home.[1] Jump ahead 11 years and that number continues to grow. We are asked to press one for English and have the option of reading everything from a manual to a menu in Spanish. While Spanish is the second most spoken language here in the U.S., there can be regional variation.

Of the more than 18% who don't speak English as their first language, most, if not all, will see a physician here in the U.S. at some point. The physician they choose may not speak their native tongue.

According to a 2009 UCLA study 13% - nearly 31,000 patients who have asthma problems in California - experience problems understanding their doctors. This rate is more than three times higher than those who speak English very well (or who are native English speakers). The rate of ER/Urgent care visits for asthma patients who struggle with English is 77% higher than for similar patients who can communicate with their doctor. This adds to the number of unnecessary, expensive ER visits.[2]

Title VI of the Civil Rights Act prohibits discrimination based on race, color or national origin.  The Act goes even further in protecting against discrimination of those with limited English proficiency - also known as "LEP".

Health care providers receiving Federal financial funds are mandated by law to take adequate steps ensuring those who can't speak English are provided with the necessary tools to clearly communicate with their physician.  Physicians who are unsure whether they receive financial assistance should think twice.  Physicians who receive reimbursements from Medicaid or Medicare are recipients of Federal financial assistance, and, thus must comply with Title VI requirements for language assistance. 

The challenge goes beyond compliance with government rules.  Failure to comply can also result in civil liability claims.  In 1999 Omar Aghazadeh visited the Maine Medical Center. Aghazadeh spoke Farsi; not English. Because of the language barrier; Aghazadeh asserted that he did not receive the proper treatment. He filed a law suit - in English.  This suit distilled to the claim the patient was discriminated against merely because he did not speak English.[3]  

The type of language assistance that must be provided to LEP patients depends on a variety of factors including:

-The size of the medical practice

-The size of the LEP population

-The nature of the service

-The total resources available to the medical practice

-The frequency with which particular languages are encountered

If the Office Civil Rights ("OCR") gets a complaint about a noncompliant physician's office, they will inform the practice in writing of its findings and identify the steps that must be taken to become compliant. If the practice chooses to ignore the OCR's helpful hints,  the OCR is empowered to terminate any Federal funding (after an administrative hearing).  

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ABOUT THE AUTHORS:   Jeffrey Segal, MD, JD, is founder and CEO of Medical Justice Services.  Mike Sacopulos, JD, is general counsel for the organization.  Run by physicians for physicians, Medical Justice, is a membership-based organization that offers proven services and proprietary methods to protect physicians' most valuable assets - their practice and reputation. The company offers proactive services to deter frivolous medical malpractice lawsuits, prevent Internet defamation and provide proven strategies for successful counterclaim prosecution. Medical Justice works as a supplement to conventional professional liability insurance.



[3] Aghazadeh v. Maine Medical Center; 1999 WL 33117182 (D. Me)


Last Updated on Tuesday, 22 March 2011 17:14

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